NYT: My, many of these ObamaCare premiums aren’t really as low as they seem, are they?

posted at 9:41 am on December 9, 2013 by Erika Johnsen

In the latest in the Paper of Record’s recent series on their gradually creeping realization that There Is No Such Thing as a Free Lunch: ObamaCare Edition, the NYT has a story out this morning that hones in on the Obama administration’s desire to tout premiums that sound as gloriously low as is humanly possible — even if that means deliberately obfuscating the ways in which insurance companies are now looking to make up the increased costs of the overhaul in other, less immediately obvious areas.

The Obama administration will herald what appear to be “affordable” premiums available to so many lucky Americans through ObamaCare all day long, “but as consumers” [and, evidently, the NYT] “dig into the details, they are finding that the deductibles and other out-of-pocket costs are often much higher than what is typical in employer-sponsored health plans.” There’s plenty of cushion on behalf of ObamaCare in the piece, but the overriding message I’m reading is that ObamaCare is not the wondrous and automatic cost-saving measure officials are touting it as, and that a lot of people, if they’re ineligible for ObamaCare’s more blatantly redistributive effects, are going to have to pay for all of the added “benefits” they now have no choice but to include in their plans somehow:

Until now, it was almost impossible for people using the federal health care website to see the deductible amounts, which consumers pay before coverage kicks in. But federal officials finally relented last week and added a “window shopping” feature that displays data on deductibles.

For policies offered in the federal exchange, as in many states, the annual deductible often tops $5,000 for an individual and $10,000 for a couple. …

Mark A. York, a 60-year-old freelance writer in Hailey, Idaho, said he began shopping after he received a letter saying that his current insurance policy would be canceled because it did not meet the requirements of the health care law. In the exchange, he said, he found policies with premiums similar to what he is now paying, $440 a month, but “the deductibles were so high — $4,000 to $6,000 a year — that it defeats the purpose of having insurance.” …

Federal officials often point to premiums as evidence that the health care law has made insurance affordable. “Nearly six in 10 uninsured Americans can pay less than $100 a month for coverage in the health insurance marketplace,” Kathleen Sebelius, the secretary of health and human services, has said.

Except that those miraculously low premiums aren’t really much of a favor if they’re accompanied by much higher deductibles, co-payments, and drastically limited provider networks, are they? There’s been a sizable and obviously deliberate lack of straightforwardness going on with this law, and those aren’t the only hidden and/or “unexpected” costs that consumers might now find themselves facing, as the WSJ reported the other day:

Americans with chronic illnesses—who are expected to be among the biggest beneficiaries of the health law—face widely varying out-of-pocket drug costs that could be obscured on the new insurance exchanges.

Under the law, patients can’t be denied coverage due to existing conditions or charged higher rates than healthier peers. The law also sets an annual out-of-pocket maximum of up to $6,350 for individuals and $12,700 for families, after which insurers pay the full tab.

But depending on the coverage they select, some patients on expensive drug regimens could reach that level fast. Some medications for conditions including hepatitis, rheumatoid arthritis, HIV and cancer can retail for thousands of dollars a month, and some plans require patients to pay as much as 50% of the cost.

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The Obama administration will herald what appear to be “affordable” premiums available to so many lucky Americans through ObamaCare, “but as consumers” [and, evidently, the NYT] “dig into the details, they are finding that the deductibles and other out-of-pocket costs are often much higher than what is typical in employer-sponsored health plans.”

So to check what the deductibles and out-of-pocket costs are in an insurance plan instead of just reporting the premiums is “digging into the details?”

That probably explains how the media gets virtually every story they cover so badly wrong.

Luckily, the Obama administration will let you work off your “premium” debt to society: Trash pick up by the side of the highway, washing cars for administration big-wigs, babysitting the kids of IRS administrators in Cincinnati…there are lots of possibilities.

Federal officials often point to premiums as evidence that the health care law has made insurance affordable. “Nearly six in 10 uninsured Americans can pay less than $100 a month for coverage in the health insurance marketplace,” Kathleen Sebelius, the secretary of health and human services, has said.

I’m a fan of HSA’s because ‘First payer’ out of pocket costs tend to provide market pressure down on pricing.

It occurs to me that *THIS*:

In the exchange, he said, he found policies with premiums similar to what he is now paying, $440 a month, but “the deductibles were so high — $4,000 to $6,000 a year — that it defeats the purpose of having insurance.”

might also, for exactly that reason. If there’s any genuine price improvements via this law, and I really don’t think there will be, I’d look to the high deductibles as the cause.

According to the evil Dr. Emmanuel, we CAN keep our doctor, if we want to pay more. How about we just junk the entire ObamaCare law and just pay for our doctors out of pocket then? It can’t be any more expensive and then WE DO get to keep our doctors without having to buy ObamaCare.

Mark A. York, a 60-year-old freelance writer in Hailey, Idaho, said he began shopping after he received a letter saying that his current insurance policy would be canceled because it did not meet the requirements of the health care law.

I hope Mr. York sends a letter of thanks to the President. He prolly didn’t realize that his old capitalist insurance failed to cover the pill, his probable maternity OBGYN visits or that abortion he’s been eyeing. He can finally get that mammogram now too.

Of course, all of that will be covered once he pays his great and glorious people’s deductible, but at least some fat-cat misogynist insurance executive won’t be smoking a cigar on his premiums!

Federal officials often point to premiums as evidence that the health care law has made insurance affordable. “Nearly six in 10 uninsured Americans can pay less than $100 a month for coverage in the health insurance marketplace,” Kathleen Sebelius, the secretary of health and human services, has said.

Boy these people are still trying to push this brick over the finish line so that they can declare victory or something. They are utterly deaf with the concerns being raised by ordinary Americans. It is their Achilles heel.

Boy these people are still trying to push this brick over the finish line so that they can declare victory or something. They are utterly deaf with the concerns being raised by ordinary Americans. It is their Achilles heel.

Happy Nomad on December 9, 2013 at 10:08 AM

You don’t need to cross the finish line to declare victory. By Sep DWS will be convincing us that Ocare is the greatest political triumph of the modern era.

Mark A. York, a 60-year-old freelance writer in Hailey, Idaho, said he began shopping after he received a letter saying that his current insurance policy would be canceled because it did not meet the requirements of the health care law. In the exchange, he said, he found policies with premiums similar to what he is now paying, $440 a month, but “the deductibles were so high — $4,000 to $6,000 a year — that it defeats the purpose of having insurance.”

Here’s what I don’t get. Did Obama and the Dems honestly think people wouldn’t notice this? Four Americans dying in Benghazi? Yeah, I hate to say it, but most people in this country probably aren’t even aware of it. But when something hits a person’s pocketbook like this, they’re gonna find out and rest assured all the spin in the world won’t put them at ease.

Here’s what I don’t get. Did Obama and the Dems honestly think people wouldn’t notice this? Four Americans dying in Benghazi? Yeah, I hate to say it, but most people in this country probably aren’t even aware of it. But when something hits a person’s pocketbook like this, they’re gonna find out and rest assured all the spin in the world won’t put them at ease.

Doughboy on December 9, 2013 at 10:14 AM

I’m at the point where I figure they don’t even care. I suspect they calculated most of the pain would fall on the middle class rubes in flyover country who don’t vote democrat anyway. That those folks would take their lumps silently like they always do. They also calculated on the media to whitewash this for them in a big way…downplaying the pain (junk plans, etc..) and trumpeting the few “success” stories out there.

They are counting on the 7-10 million or so…from the moocher/looter class who will benefit from taxpayer subsidized health insurance to repay them with their votes. And with all the info being gathered thru the navigators and exchanges it will make an easy get out the vote vehicle to reach these people.

They are counting on the 7-10 million or so…from the moocher/looter class who will benefit from taxpayer subsidized health insurance to repay them with their votes. And with all the info being gathered thru the navigators and exchanges it will make an easy get out the vote vehicle to reach these people.

HumpBot Salvation on December 9, 2013 at 10:21 AM

These 7-10 million have been loyal democrat voters for a very long time… no gain there…

According to the evil Dr. Emmanuel, we CAN keep our doctor, if we want to pay more. How about we just junk the entire ObamaCare law and just pay for our doctors out of pocket then? It can’t be any more expensive and then WE DO get to keep our doctors without having to buy ObamaCare.

dirtseller on December 9, 2013 at 10:02 AM

Right now, you HAVE to buy Obamacare, and now they tell us that to keep our doctor, we have to pay for THAT out of pocket.

Kinda like us paying taxes for the local school and then paying private school tuition on top of that because the local schools are a flat-out mess!

Charlatan – (Also called a swindler or mountebank), is a person practicing quackery or some similar confidence trick in order to obtain money, fame or other advantages via some form of pretense or deception.

He does not try to create a personal relationship with his marks, or set up an elaborate hoax using roleplaying. Rather, the person called a charlatan is being accused of resorting to quackery, pseudoscience, or some knowingly employed bogus means of impressing people in order to swindle his victims by selling them worthless (“health insurance”* ), and similar goods or services that will not deliver on the promises made for them.

“If you like your health insurance you can keep it” – a lie
“If you like your doctor you can keep him” – a lie
“You premiums will go down on average $2,500″ – a lie
“The uninsured will be covered” – a lie. Even if free the deductibles are so high there is no coverage.
“People with pre-existing conditions will not be denied and be covered” – a lie. There is no coverage until after significant deductibles.

The pitch is a swindle.
The website is a swindle.
The coverage is a swindle.
The claims are a swindle.

By 2017 the health insurance industry will be in ashes, we will be at war with China, Iran, and Russia or each will dominate Asia, the Middle East, and Eastern Europe.

I guess now they’re starting to read the law. Pity they didn’t take a quick peak at it four years ago. Thanks NYT, appreciate the revelation. What next? Maybe they’ll find out I won’t be able to keep my,my doctor, my provider, and my employer can decide to drop me.

I was scrutinizing and comparing some of the Obamacare plans – my state BCBS website made it pretty clear and easy – and some of the policies being offered don’t have nearly the types of coverage that I have on my once cancelled/now reinstated policy.
And if you don’t qualify for a substantial subsidy, the premiums for some of the *better* plans are going to end up out of reach for many middle class consumers.

These 7-10 million have been loyal democrat voters for a very long time… no gain there…

mnjg on December 9, 2013 at 10:32 AM

I agree that the looter/moocher class is a long time democrat constituency but still think they planned on picking up millions of new voters because of obamacare by giving them even more incentive to get out and vote. This demographic is still less likely to get out and vote in comparison to the middle class so they could pick up millions of new voters. The ads write themselves…don’t let the evil rethuglicans take away your health insurance.

This is the law of the land, the Democrats will lie, cheat, steal, and do whatever they can to make sure this law last long enough to drive the insurance companies into the ground. The Republicans won’t do a thing to overturn it. Our lives are now as serfs, enjoy your new overlord.

Kellye Norris, 53, of Dallas said that after trying for more than a month, she completed an application on the federal exchange and enrolled in a Cigna plan with a premium of about $500 a month and no subsidies.

“My deductible is nearly $3,000, which is ridiculously high, in my opinion,” Ms. Norris said. “But as someone with pre-existing conditions, I’m grateful to be able to buy insurance at all.”

To be able? You mean forced sweetheart. You’re paying way more than my family. Welcome to junk insurance.

I’m a fan of HSA’s because ‘First payer’ out of pocket costs tend to provide market pressure down on pricing.

BritCarGuy on December 9, 2013 at 10:02 AM

I was discussing Obamacare with an uncle at a Christmas gathering over the weekend. He wanted to know my proposed solution…

1) The Federal Government provides an HSA card at birth, with no annual caps or restrictions on who can put money into it, or how much… whether relatives, employers, government welfare plans. This would also have the side benefit of reducing the number of “pre-existing conditions” since it would de-couple insurance from employment.

2) Allow the HSA funds to be applied to health insurance premiums.

3) Implement tort and malpractice reform to lower medical costs.

4) Reduce paperwork regulations that choke the life out of independent practices. Reduce restrictions so that if a doctor wants to setup a practice based on healthcare membership monthly charges, they can.

5) Require providers to provide a “good faith estimate” of costs when requested. This would dissolve the secrecy surrounding costs and allow people to compare costs.

You mean the subsidy doesn’t cover both the premium and the deductible? I’m shocked, just shocked . . .

sewer urchin on December 9, 2013 at 11:08 AM

Just wait until the slower among us finally realize that “enrollment” is not the same thing as access. If you find a doctor, you can see a doctor. Period. Maybe. Okay, not so much but you do have health insurance!

A kid who is earning 20 – 25,000/year probable has maybe $350 in the bank. They will NEVER hit that deductible. So the money paid into the premium is a complete waste. It wasn’t so bad until getting insurance became mandatory under The People’s Glorious Five Year Plan Insurance Mandate And Gulag Relocation Invitation.

I’ve been self insured since my late 30′s when I was in my mid 40′s I decided to purchase a CATASTROPHIC policy that was DIRT CHEAP….. it’s deductible was 5 grand……. WELCOME TO THE NEW NORMAL….

BY THE WAY…. I never had cause to access the benefits of that policy… kinda wish I took those premiums to the other Casino’s in Vegas and laid it on the craps tables…… but at least the decision was mine…. YOU don’t get that choice NOW….. AIN’T freedom n’ America great !!!

Vegas has a term for a 440 dollar a month premium with a 5 grand deductible …. They call you CHUMP.

First, let me say I am in no way a supporter of Ob@m@c@re (now a racist term according to Melitha Harrith Perry), but my coverage will improve and premiums go down.

Being self employed and paying for our own insurance… It costs us $1100 a month now. Another year of increase and not only would it be on par with our mortgage payment, but we would no longer be able to afford it. Our deductibles are higher than ANY I see on the exchange – $7,500 individual/$15,000 family. I’m trying to figure out why everyone is complaining about the deductibles – does anyone have any substantial deductibles now (before Ob@m@c@re)??

After subsidies, our premiums will total $100-$300/month depending upon what plan we choose. Deductibles will be half of what we have now.

My point is, maybe this attitude that insurance should cover every little thing is what has caused the rapidly rising costs. No one knows what anything really costs, because they pay their deductible at the doctor’s office and never see the real bill.

Insurance was intended to cover the big stuff. Do we turn to our car insurance company when we have a minor problem (get a ding in the door) or for preventive services (oil change, brake rotors)? Or do we cover those ourselves as a normal part of the cost of owning a car?? If we took everything little thing to the car insurers, the costs would skyrocket, also.

Maybe if consumers had an idea of what health services actually cost, they would have rebelled years ago. The majority are so insulated from the realities, the costs have soared with no one realizing it, unless they get stuck with a huge bill. My son at college got pneumonia 2 years ago. One night at the hospital for xrays, etc., we had to cover $1350.00.

We don’t want to go on Ob@m@c@re, but we have no choice. We can only justify it by thinking of it as helping to crash the system sooner so we get a revolution in this country that throws the progressives out of power…

The irony is that this is the only “feature” of Obamacare that will do us any good. By having copays and deductibles higher the consumer of health services will have an interest in lowering the costs of what they are consuming. People will start to care about tort reform when they are paying the bill for overly defensive medicine. They will start to care about shopping based at least in part on cost when they know that someone else is picking up the tab. They will be slower to go to the doctor for imagined illnesses when the visit will cost them something.

Connecting consumption with the cost of the services consumed is the only viable way to “bend the cost curve.”

440 a month and a 5 grand delectable…… 9 thousand 8 hundred you gotta pay before coverage kicks in (and then it ain’t 100% coverage —-read the fine print)… ahhh look on the bright side… you are buy’n a lot of birth control pills for Susan Fluke

Obamacare is simply another Massive, Massive, welfare program designed to complement the others, food stamps, obamaphone, HUD housing, free lunch, AA, etc! It is reparations wrapped in the guise of healthcare reform! It delivers the knockout punch of the blacks “Knockout” game to working people to cover the Democrats Low-info voters! It destroys the well being of the majority to benefit the minority! It will be like making all cities into Detroit in order to to make all cities equal!

the deductibles were so high — $4,000 to $6,000 a year — that it defeats the purpose of having insurance.”

When the GOP actually makes a move to repeal this thing, why not just offer subsidized, if necessary, catastrophic medical coverage? Young people would buy it and that would subsidize the sickest. And if you wanted to leave the corporate/government world, you could buy your own policy until you build up your business.

Precisely. Ensure that everyone can have catastrophic coverage. The taxpayers should not be paying for every birth control pill or sniffle. Nor, however, should we allow people to suffer serious pain or illness without treatment. The D’s have been successful in making it a choice between full, complete coverage for all or allowing people to die in the streets. There are other options.

The company I work for (which is the recipient of an employer mandate waiver) just closed open enrollment for 2014. The plans offered were more expensive (with higher deductibles and co-pays) than previous years, offered less choice of doctors, hospitals and clinics AND you must meet the ENTIRE out of pocket payments before the insurance kicks in a single penny! Many of my co-workers VOTED for Obama (twice) so naturally I was able to take this opportunity to educate them on the folly of their votes – and they were willing to listen!

I still can’t believe nobody has lost their job over this whole fiasco.

Saverio on December 9, 2013 at 12:16 PM

There were four Americans butchered like cattle in Benghazi and no one lost their job then either. This is neither a noble nor ethical administration. Plus, a fish rots from the head down. If we hadn’t spent the last five years watching Obama be-bop and riff his way past any real accountability we may have been able to create an environment where massive, unmitigated screw-ups resulted in tear-filled apologies and resignations.

The miserable feeling I had on the night of the election when it became clear that Americans had foolishly reelected the Charlatan-in-the-White-House is somewhat soothed by the shock and outrage that the fools who reelected him are feeling at the predictable happening to THEM rather than the EVIL Republicans…but not really. It still feels miserable to know we are stuck with him for 3 more years. At least now the pain is also felt by those responsible for reelecting him.

A physician colleague told me that in some states, if a patient is on a non-formulary medication, they have to pay the entire amount and IT DOESN’T COUNT TOWARD THEIR DEDUCTABLE!

Say you aren’t controlled on Lipitor and have to take Crestor but it’s non-formulary. That’s $1200 + out of pocket a year that is in addition to premiums and doesn’t count toward your deductable. I have not seen this in print, but I would not be surprised if it’s true. The hits just keep on coming.

I hope Mr. York sends a letter of thanks to the President. He prolly didn’t realize that his old capitalist insurance failed to cover the pill, his probable maternity OBGYN visits or that abortion he’s been eyeing. He can finally get that mammogram now too.

Of course, all of that will be covered once he pays his great and glorious people’s deductible, but at least some fat-cat misogynist insurance executive won’t be smoking a cigar on his premiums!

Now that we’re pricing health insurance based on how much people earn why not sell cars the same way? You go down to the dealership and ask how much a car costs. The dealer asks how much you make. If you say $50,000 a year the car costs $30,000. If you say $25,000 a year the car costs $15,000. Instant income equality! The dealer will of course know your true income by scanning your standard issue Obamaphone that is bio-linked to the chip in your arm.

Umm….the web site is guaranteed to lose your personal info to hackers…and IF you can get in and actually find insurance it will cost you an arm and a leg, almost to the point of being unaffordable…it is the worst program ever imposed on the American people in this nation’s history & is the biggest SCAM perpetrated against every American citizen by a President/by the government – and no one is being held accountable.

Communist, Socialist, Muslim Extremist-Sympathizing/Allies, racist, hate-spewing Anti-Colonialist, elitists now run the government. They are violating both the rule of law and US Constitution. The nation’s enemies now run the nation. Elected officials, fearful of both being ridiculed and of possibly losing their lofty, posh, elitist jobs are paralyzed like deer caught in an on-coming car’s headlights, unable or unwilling to do what is necessary for the literal survival of our nation from the enemies within Karl Marx warned of when he declared the US would never be defeated from without but rather from enemies within.

To these worthless ‘servants of the people’, over 2,000 violations of the Constitution, the largest criminal / Un-Constitutional SCAM in our nation’s history that is destroying the US Health Care system, betrayal and sacrificing Americans to our enemies, ordering our military to aid the perpetrators of 9/11/01 take over their own country, aiding the Muslim Brotherhood terrorists take over our FORMER allies Egypt, using the IRS to target and punishthe president’s political enemies – which is still going on, re-writing the Patriot Act and declaring every American citizen to be a threat to the US to justify spying on everything the American people are doing…none of this is enough to begin Impeachment proceedings against this internal/domestic THREAT! If THIS isn’t worthy of Impeachment, nothing wil ever be. Then again, it won’t matter…by the time Obama is out of office, what remaining few liberties we have under the Constitution will either be trampled or stripped away, the nation will be irrepairably destroyed, our collapse imminent.

Will the last American out please bring the flag….before you go, however, I encourage every American to rise up and take everything – all of their wealth and possessions – our politicians have obtained/hoarded at the expense of Americans they have victimised in order to ammass that wealth. If America collapses on their watch, ensure Obama’s beloved ‘share the wealth’ concept is carried out in great detail. Take back what is Americans from those who strip-mined it while they rode the nation down!

You make some good points about the sanity of the insurance system that inflates costs by inserting itself into routine low-cost/ risk issues, but all the signs are that there will be payment problems regardless of what Obamacare ™ web-sites say and ultimately your doctors will have to decide how long they want to work for no pay.

I’m still scratching my head over how HHS was surprised that healthcare.gov was overwhelmed by people trying to log in when the law requires them to have health insurance.

By their own estimate they expected 7 million people to sign up by the end of March (originally).

Let’s see… hmmmm… 7 million divided by 6 months is over 1 million people a month, which is over 33 thousand a day who need to actually commit and doesn’t take into account everyone else who may be shopping multiple times to find a plan.

But wait, if you want to be insured by 1 January 2014, then you needed to sign up and pay by 15 December (originally).

So that is potentially the majority of 7 million people who might want to have insurance by 1 January.

That would be 7 million people divided by about 75 days available to sign up and make a payment to be covered. That comes to potentially 93 thousand people a day to successfully enroll.

And they were surprised that their website capacity for 25 thousand a day (even if it actually worked) was overwhelmed when those 7 million people are required by law to sign up?

HHS must have taken the Common Core math and logic classes when deciding what capacity they needed for the website.

I don’t see how Obamacare survives. If the Republican take control of the Senate, they may well have enough Democrats willing to stop their own bleeding to have a veto proof dismantling of Obamacare. Even if they just get close, the pain may be too much for too many Democrats to allow Obamacare to continue.

As long as Republicans control either the House or the Senate, single payer will never see the light of day. But turning around all of the changes Obamacare has already implemented will be very difficult–especially the pre-existing conditions. Politically difficult to reverse that and leave those that did sign up for it suddenly out in the cold again.

However, almost anything would be better than Obamacare and we need to return health care back to the private market and we need to restore the doctor patient relationship. We also need to let people decide what kind of insurance is best for their particular circumstances.

But I’ve learned to never underestimate the ability of the low information voters to get it wrong every time.